- Bob and Brad
the two most famous physical therapists on the internet.
- Hi, I'm Bob Schrupp, physical therapist
- Brad Heineck, physical Therapist.
- And together
We are the most famous physical therapist on the internet
- In our opinion, of course.
- Yep. And that's all that matters, Brad.
- That's right.
- Okay. Today,
We're gonna talk about why you should avoid back
Surgery at all costs and, and try this stuff instead.
A lot of this is from the book Paindemic.
I'll put the name down below and we did a review
On this book before, but it's written by a doctor
And she basically said, there's no emergency reason
For surgery.
You should definitely try a conservative approach first.
- Right.
- I mean, what, why go into surgery right away?
But a lot of people do have that in mind
That I'm having pain.
And even if they've had pain for a long time
They think they have to have surgery.
And the fact is, the surgery may not take it away.
- Right.
- It might make it worse
Or just giving you more issues to deal with.
- Exactly.
We both worked
With people that have had surgeries and complications.
They continue on, on the other hand,
some surgeries do well quickly.
- Yeah. We're gonna talk
about which ones and which case we think you
definitely should have the surgery.
- Right.
- The quote that this doctor said
Which I thought was really kind of telling was,
She goes I know plenty of pain medicine
Physicians and surgeons who would avoid back surgery
Like the plague if they were patients.
I mean, so that's kind of really.
- Yeah.
- It makes you think
- Dramatic, but when is it helpful?
Okay. If you've got a growing mass, I mean
You've got cancer in your spine and it's pushing on a nerve
- Right?
- I mean, you gotta have surgery to get that removed
- Right.
- The same with a blood clot, you can get
A blood clot on the spinal cord.
- Yep.
- And that would, you know, again, compressing the spine.
You want to get it removed.
- And those are the kind
Of surgeries are not too involved typically.
They take the mass out
You have immediate relief when you, you know
When you're leaving later that day
Or the next day,
Things are much better.
- Right. If you have a herniated disc and, first off
I'm gonna put this video on at the end.
If you do have a herniated disc
You definitely wanna try the Mackenzie method.
- Sure. You bet.
And if it doesn't respond to the Mackenzie method
And you're getting foot drop, you know
Your weakness in the foot,
Decrease sensation in the foot,
You know, numbness, tingling.
Then it's starting to look
At the time that you should probably have have surgery.
- Right. And of course the big red flag, if you have
if you can't control your bowel movement.
- Bowel or bladder. Yeah. That's an emergency surgery
- Right. That's going to the hospital right now.
- Yeah. That's
- 9 1 1, or
- Exactly. Very good point, Brad.
So part of the problems with surgery too, Brad
Besides the normal risk factors
Like infection and bleeding and nerve injury
Is that quite often they end up doing a fusion.
- Sure.
- And the problem with fusions
Is that you become a repeat customer.
So let's say they, they fused the low back here.
Okay. So now there's no movement
At these lower three segments.
- Right. So in other words
The fusion is the vertebra they taken literally.
And they may put hardware in there
So that they are physically mechanically attached.
And there's no movement between the vertebrae
Which is not natural.
- Right. And so what happens now,
Because the movement's gotta come from somewhere.
- Right.
- I mean, you're bending.
So now all the movement is coming from the
The levels above it.
- Right.
- And so there's gonna be more movement
On those and more stress on those.
- Right.
- And eventually those start to break down
And usually have back problems at those levels then.
And this is exactly what happened to my mom.
First off, my mom was definitely a candidate for surgery.
She had weakness and pain in the leg.
I mean, to the point it was, it was a 10 outta
10 and she got a drop foot.
- Yep.
- So she had the surgery, had a fusion.
Three years later
Two years later
We had to have another surgery because
It all wore out on the levels above
And she was back again.
- Right.
- And that's, these surgeries are hard surgeries
To go through.
- Right.
- They are not fun surgeries.
They're, I mean, you're out for a long time and
You're not being productive in life.
So the other thing which I'm just gonna throw
There in as an aside, there's really no financial
Incentive for, you know, hospitals and surgery
Centers and surgeons not to do surgery.
I mean, they're, these are expensive surgeries
And they do well with them.
I'm not saying, that's why they're doing it.
- Wow, Bob. That is cynical.
- I know it's cynical, but
- Might be true.
That's why you really wanna push
For a conservative attempt first before you, you know
Go through the surgery.
- As a matter of fact, on a comment,
I just read yesterday, someone wrote in
Talked about his back pain and the attempts he went
Through and they, he said, I'm not having surgery.
He continued to research conservative treatment
And now he is doing fine.
- Yeah. Yeah.
- As a matter of fact,
He watched some of our videos that helped him out.
He was thanking us.
Yeah, one of the worst things is that the statement
That you don't wanna see, which you do hear quite often is
If I would've known what I know now I wouldn't have
Had the surgery.
- Right.
- I mean, you know, they, they were, they were hurting
But they weren't hurting to the point where they
Were getting weakness and stuff like that.
I'm sorry with some back pains, you're gonna
You're gonna have pain.
And this is, we're gonna talk about, these are
The things you wanna try instead.
- Sure.
- So three, three kind of a three pronged approach.
One you're gonna definitely wanna do something aerobic.
So, and Brad, you're a good example here.
Brad's got Spondylolisthesis
We just did a video on this and
I could see a lot of people going in
And trying to push for surgery or something like that, Brad.
- Right. Because, when it started that I had
For two years straight
I had a back pain every day at work.
It wasn't severe, but it was nagging.
Sometimes it got severe.
I would self treat
And I knew I didn't want to have surgery because
Of what we're just talking about and now doing, you know
and you don't have to be serious aerobic exercise.
You need to find an activity.
- Brad is the king of this.
I mean, you've done very well with this.
Brad, you ran for years and now you're biking.
- Right.
- And you're swimming
- I had to stop running because
of the back pain for two to three years basically.
And now I'm just starting to get back
To where I was six years ago.
So I had to take some time off
Of the running a little bit, but then I started biking more.
I started swimming more.
You don't have to do those, but those are some options.
- It just really helps.
The more you can get oxygen to the area.
And they've found through studies that
If you can do 20 minutes of aerobics
And which means just 20 minutes of walking even,
- Right.
- It really gets a lot more oxygen to that
Area and helps it.
It's gonna help you feel better.
It's gonna stop.
It's gonna heal better.
- Yeah. It's not like you gotta put the leotards on and
Go to a class and get all sweated up.
You know, that's another story.
- Even just staying active for 20 minutes doing aerobic.
So all right.
The second thing is you you're gonna wanna try to
Find what movements you can do because everybody generally
You can find some movement that you can do with your back.
That's gonna make it feel better.
Let's show some
of them Brad. I'll go ahead and lay down here.
- Yeah.
- For some of you
It might be doing knee to chest.
- Sure.
- Single knee to chest.
And then you can even go one
And another and even do double knee to chest.
- Right.
- Depending what your problem is.
Some people it's gonna make your problem worse.
- Right.
- That's gonna make a herniated disc, usually worse.
- Sure.
- The one that most people can do Brad without
Fail is the rotations like this.
- Right.
- So like you said, a lot
Of times you can't have people keep their feet
Or knees together
Right?
- Yeah. Going back gentle mobility.
And these guys, if you're in a really acute flare
Up or your back is really sore, you gotta take
This is more for that chronic pain that you can
Still work with on a daily basis.
And you're trying to figure out how to get it
better over time.
- Exactly. But I don't know when I had my pain episode, I
I was able to do some of these.
- Yep.
- And sometimes you might
- And, you might find that you can only go one direction.
That's fine.
Just do the one direction right now.
Or you may find out that it's feeling better
and you can actually start really rotating.
- Right.
- Like this really start getting
And you can move your heels up or down, depending on
Where, what part of the back you're working on.
- Right.
- This is one of those things you just, you need to work
With your body, be patient, do not do the
That whole philosophy of no pain, no gain.
- Right.
You're trying to find the movements that don't hurt.
- Right.
- And this is a popular one too, that works out
well, a lot of times with the herniated disc
And we're gonna put this at the end too, is the
A video that you can click onto the Mackenzie
Approach where you're actually doing some extensions
Like this.
- Right.
- And we got a whole video on this
So I'm not gonna go too deep into this now, but
- Just click on it at the end.
And there's more details on treatment for this.
- Right. But that's an excellent one to do too.
- Yeah.
- Find the movement that you can do and do it
Do it a couple times a day and, and that's gonna help too.
- Right.
- The final thing is you're gonna wanna do
Is some strengthening and Brad's actually
We're gonna do a whole video on this.
It's gonna be put up after this one.
- Right.
- So stay tuned and, and eventually I'll link to it.
- Yeah.
- It'll be exciting.
Fun. What else could it be,
Bob?
- I don't know.
- No, but really strengthening exercises should not
Irritate their back.
They should get the muscle working.
- Well, I think, give the example in your case, Brad
I think it's made the difference where you were able to
There was things you couldn't do.
And then you started doing strengthening
And now you can do them.
Right?
- Right. And this takes some time.
It doesn't happen in a week or two, typically.
- This is a dedicated person.
If you you're gonna do strengthening
But it's so good for you overall, even.
I mean, it's gonna help your core.
It's gonna make you look thinner.
- Right.
It's gonna, you know, and strong bike
- Strong, like bull there, bull strong, like bull
- There's the bull.
And we all know where else the bull is.
Okay. Thanks for watching.